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Sharon has dealt with the pain all her life. In fact, she still had a sickle cell crisis a few weeks before the pregnancy test results came in positive.

Women like Sharon often wonder how to deal with pregnancy due to the risks associated with their genotype. Thankfully, due to the major advancements in medicine, it has become possible for women with Sickle Cell Disease to triumph through pregnancy and delivery process.

What Is Sickle Cell Disease?

Sickle cell disease (SCD) is an inherited genetic condition in which the body produces abnormally shaped red blood cells under stressful conditions. These abnormal red blood cells can be C-shaped or sickle-shaped. They have a high tendency to stick to each other.

They also aren’t as flexible as the normal shaped cells making it difficult to navigate tight corners in tiny or branching blood vessels and so on.

These cause blockages cutting off blood supply to areas where the vesses were orignally headed.

This is the cause of the excruciating pain and damage to tissues and organs that have their oxygen supply cut off. Such events are the cause of strokes bone infections and and so on.

Effects of SCD on Pregnancy

1. Sickle Cell Crisis. This is also known as painful episodes. It occurs when a sickle-shaped or C-shaped red blood cell block blood vessels that supply blood to the bones. This crisis can last several hours to several days. And it varies in severity depending on the person and the crisis. The crisis can occur in pregnancy due to the increased physical stress the mother is passing through.
2. Anaemia. Anaemia is a condition in which the body does not have enough healthy red blood cells. This results in a reduced supply of oxygen to the various organs of the body. Pregnant women with SCD are at a higher risk of experiencing anaemia during pregnancy that at other times.
3. High Blood Pressure. Women with SCD are at risk of developing high blood pressure and preeclampsia (a pregnancy complication characterised by high blood pressure and organ injury ) during pregnancy.
4. Women with SCD are at risk of some pregnancy complications. These complications include miscarriages, low birth weight, and pre-term delivery.
5. Women with SCD are more likely to deliver through a caesarean section rather than a vaginal birth due to the increased complications associated.

I have Sickle Cell Disease…..What should I do?

Living with sickle cell disease means that you will need special care and attention during your months of pregnancy. You will also need to maintain a good diet and stay hydrated in order to stay healthy. When you are ready, your pregnancy needs to be planned for. You should be managed at a specialised center by a team of health personnel such as – blood specialists (haematologists), obstetricians etc.

A few tips…

1. Some of the medication you were on before pregnancy such as hydroxy urea or ACE inhibitors may not be compatible with pregnancy. Please inform your doctor 3 months before you plan on getting pregnant so adjustments can be made.
2. Your antenatal check-ups may be more frequent than other pregnant women without SCD. This is because of the nature of your health and the need to stay ahead of any complication that is likely to occur.
3. Apart from your routine pregnancy medication, you may be prescribed with some medication ( tablets and/or injections) to be taken throughout pregnancy. These are to prevent crises, and conditions such as pre- eclampsia.
4. Be careful of the medication you use. Don’t use any drug without informing your doctor. This is because not all drugs are safe during pregnancy. Therefore, ensure to take only prescribed medication.
5. There may need to receive one or more blood transfusion during pregnancy. This can serve as a prophylactic measure (prevention) to prevent complications.
6. Because of the nature of the disease, people with SCD usually have excess iron stored in their blood – even when they’re anaemic. Pregnant women in this condition may need to take prenatal vitamins that do not contain iron.

Conclusion

You can have a healthy pregnancy and a safe delivery even with SCD.

Follow your doctor’s guide and instructions. Be sure to be in close and frequent communication with your doctor while pregnant. This will help in close monitoring of your health and early detection of any complication that may want to arise.

Everybody loves twins.

Seeing them in those beautiful matching outfits definitely triggers the ‘feel good’ hormones in all of us.

Want to know more about twins and multiple pregnancies?

Then read on, this article contains everything you need to know.

What Is A Multiple Pregnancy?

A multiple pregnancy is one with two or more babies growing in the mother’s womb. It is the less common alternative to a singleton pregnancy, where there is only one baby.

How Does A Multiple Pregnancy Happen ?

There are two main types of multiples; Non-identical (fraternal) and identical multiples.

During ovulation, usually, only one egg is released.

However, if more than one egg is released and they are all fertilized by sperm separately it results in a fraternal or non-identical multiple pregnancy.

In some other cases, after one egg is released and fertilized by a sperm, it divides into two or more embryos before implantation, resulting in an identical multiple pregnancy.

Thus, identical twins arise when a fertilized egg divides into two in the early stages of pregnancy before implantation. Conversely, non-identical twins are formed when two eggs are released during ovulation. Separate sperm then fertilize each egg.

Identical twins have the exact same copies of genes, and they have the same sex. However, fraternal twins are not genetically identical.

What Causes This?

1. Fertility Drugs: The use of fertility drugs to induce ovulation. This can result in more than one egg released from the ovaries leading to their fertilisation.
2. Assisted Reproduction/In-vitro fertilisation (IVF).: This results in multiple pregnancy when more than one embryo is transferred to the womb.
3. Maternal Age: Women above 35 are more likely to give birth to twins. This happens because women of this age often release more than one egg in a single menstrual cycle.
4. Maternal Height and Weight: Taller and heavier women tend to give birth to twins more often.
5. Genes: This relates more the woman’s genes; a woman is likely to have twins if she is a twin or has siblings/cousins who are twins.

How Can You Stay Healthy During A Multiple Pregnancy?

1. Eat Nutritious Food: As an expecting mum of two or more, you need to eat more protein and stay hydrated. Also, you will need to eat some extra calories so that your babies will feed well .
2. Exercise: Consult your doctor to know which exercise is good for you at each stage of your pregnancy. Nonetheless, you need to avoid strenuous activities.
3. Rest : Do so much as you can. This will require support from family and friends
4. Attend Clinics Attend these regularly as directed by your doctor so that your well being and that of the babies can be closely monitored.

What Are The Risks?

1. Early Labour and Preterm Delivery: Sadly, this is quite common in multiple pregnancy – delivery is more likely to occur before a gestational age of 37 weeks. Also, the babies are more likely to have a low birth weight.
2. Hyperemesis Gravidarum (HG): This is excessive vomitting in pregnancy . It can cause a significant disruption of the fluid and electrolyte balance of the mother, requiring hospital admission for treatment.
3. Diabetes: Gestational diabetes is more likely to develop in women with multiple pregnancies. Unfortunately, this may cause respiratory distress in growing babies.
4. Preeclampsia: This refers to high blood pressure (hypertension) that occurs in pregnancy. Preeclampsia is more common in multiple pregnancies than single pregnancies.
5. Delivery: The choice of delivery depends on the number, size, position, and health status of the babies. Often times, a Caesarean section is advised for women with multiple pregnancies.
6. Placenta Abruption: Most times, multiple pregnancy affects placental function. A placenta abruption occurs when the placenta becomes separated from the inner wall of the womb before delivery.

How Will They Be Delivered?

Most twins in recent times are born by a pre-planned Cesarean section. Less commonly, depending on the weight of the babies, health status of (mum and babies), and position, they can be delivered vaginally.

How Do I Feed Them?

It is perfectly possible to feed twins exclusively on breast milk with the right support and positioning. Most twins are nursed in tandem using a rugby position. Here mum positions babies with their heads in front beside her breast and legs pointing backwards under her armpits. This mimics how one carries a purse or rugby ball.

You will need nourishing food, hydration, and good social support. Don’t hesitate to request for what you need. Get a good breast pump so others can help with feeding. It is not uncommon for families to supplement with formula.

In Conclusion,

Having twin babies is a delightful experience although it comes with its own peculiarities. Read our other article on positive signs of embryo transfer.

While expecting multiple babies, it is advisable to attend clinics regularly. This allows your doctor to monitor the health of you and your babies effectively.

Finally, the complications of multiples can be reduced and managed better when you visit your physician regularly.